Whipple surgery is an abdominal surgery that is performed most commonly for the removal of pancreatic cancer. This surgery involves resection of the head of the pancreas or complete pancreas, duodenum (part of the small bowel), bile duct, gallbladder, and maybe a part of the stomach. Whipple surgery may also be recommended for:
- Duodenal cancer
- Cancer of the bile duct
- Trauma to the pancreas or small intestine
- Chronic pancreatitis
Alternate Name of Whipple surgery
How is Whipple Surgery Performed?
Whipple surgery is performed under general anesthesia. You may also receive a spinal block for additional pain relief. To begin with, your surgeon will make either a central single incision or several small incisions on your abdomen, depending upon whether the procedure is being done as an open procedure or a laparoscopic or robotic procedure.
Whipple surgery is quite a complex surgery, in which the cancerous portion of the pancreas, duodenum, common bile duct, gallbladder, some adjacent lymph nodes, and a part of your stomach may be resected. The remaining portion of the pancreas is then reattached to the small bowel, which in turn is reattached to the stomach for the process of digestion to resume. The incisions are then stitched, bandaged, and the surgery completed.
Whipple surgery usually takes about 6 hours.
Preparation for Whipple Surgery
Your surgeon may perform several medical tests before the surgery to assess your general health status and evaluate if it will be safe to proceed with a complex surgery like the Whipple procedure.
Significant weight loss is very commonly seen following Whipple surgery; thus, it is often recommended to gain some weight before the surgery.
Strengthening your abdominal wall muscles and hip flexors with the help of regular exercise before surgery will help you return to your activities faster following the Whipple procedure.
You must tell your doctor if you suffer from any chronic diseases like asthma, hypertension, or diabetes. You must also inform him about all the medications that you are taking. You might be needed to stop certain medications and herbal supplements a couple of days before the surgery. Do not forget to tell the surgeon if you have ever experienced any adverse reactions to anesthesia in the past.
Stop smoking a couple of weeks before surgery.
Avoid food and drinks for at least 8 hours before undergoing Whipple surgery.
Remember to take all the medicines that your surgeon has asked you to take before the surgery.
After admission to the hospital, a catheter will be inserted into your arm for the administration of IV medications and fluids.
Make necessary arrangements for a hospital stay of 8-10 days.
Whipple Procedure Type
Follow-up After Whipple Surgery
You will be needing weekly follow-up visits with your surgeon for several weeks post-surgery. During these visits, your surgical incision will be checked for any signs of infection, and you will be monitored for any complications. Your food intake will also be gradually increased and strictly controlled. You will need about 2 months to regain your normal strength.
You might also be required to undergo chemotherapy and/or radiation therapy following the Whipple surgery, depending upon the severity of your disease.
Risk Factor Of Whipple Surgery
Whipple surgery is an extensively invasive surgery and there is a high risk of complications, with about 50% of patients experiencing some complications. Listed below are the most common risks associated with Whipple surgery:
- An intra-abdominal abscess (pus formation in the abdomen)
- Pancreatic fistula formation, causing leakage of pancreatic secretions and infection
- Delayed food emptying from the stomach
- Small bowel leakage
- Infection at the incisional site
- Inflammation of the bile duct (ascending cholangitis)
- Diabetes following Whipple surgery, if a large portion of the pancreas was removed.
- Weight loss
Recovery after Whipple Surgery
Recovery following Whipple surgery will be gradual and will take some time because it is major surgery.
You will not eat anything for a few days post-surgery to allow your reconstructed digestive tract to heal. You will gradually be started on a clear, liquid diet, and then to solids when your surgeon deems it fit. You might have to make some permanent changes in your diet after the Whipple surgery. Your physician may prescribe pancreatic enzyme supplementation.
Pain will be managed through IV pain medications initially, followed by oral pills after a few days.
You will be made to walk for a short distance the first day after surgery and will be encouraged to gradually increase it daily, but you should do so only with some assistance.
You will have a urinary catheter to drain urine for a few days, and some drainage tubes around the surgical incision to remove fluids.
It might be several days before you will have your first bowel movement after the surgery.